Job Description
Are you an empathetic, organized healthcare professional looking for a rewarding, fully remote opportunity in patient access and case management? We are seeking a dedicated Individualized Care Case Manager to support specialty pharmaceutical programs!
In this key remote position, you will guide patients through their care journey, ensuring they can access, afford, and remain on life-changing specialty therapies. Operating on a fixed daytime shift (Monday through Friday, 10:00 AM – 7:00 PM CST), you will monitor system accounts for new patient cases, contact insurance carriers to obtain and verify benefit details, and conduct outbound calls to confirm coverage approvals, co-pays, and dispensing specialty pharmacies. You will also assess patients for co-pay assistance, mediate complex payer/pharmacy issues, and document all interaction details in proprietary software while providing compassionate, empathetic support. If you bring strong healthcare or pharmacy benefits experience, excellent multitasking abilities, and a commitment to patient advocacy, this role offers an ideal environment to apply your expertise.
salary: $19.99 - $20 per hour
shift: First
work hours: 8 AM - 5 PM
education: High School
Responsibilities
Key Responsibilities: - Monitor system queues for incoming patient cases and maintain accurate account records throughout the approval pipeline.
- Contact insurance carriers to obtain, verify, and document benefit details, minimizing claim rejections.
- Conduct outbound calls to patients to communicate coverage determinations, co-pay responsibilities, and dispensing pharmacy information.
- Evaluate patient eligibility for co-pay programs, patient assistance funds, and alternative foundation funding.
- Mediate complex payer and pharmacy issues to achieve positive resolutions and de-escalate concerns.
- Identify, document, and submit Adverse Events in accordance with mandatory regulatory protocols.
Requirements: - Minimum High School Diploma or GED required; additional education preferred.
- Previous experience in healthcare, insurance, pharmacy benefit management (PBM), or specialty pharmaceuticals preferred.
- Familiarity with Medicare, Medicaid, commercial payer practices, prior authorizations, or medical coding (ICD) highly desired.
- Minimum typing speed of 40 WPM with strong data entry and MS Excel skills.
- Dedicated, private home workspace with hardwired high-speed broadband internet (15 Mbps download / 5 Mbps upload minimum).
- Full availability for mandatory virtual onboarding training (Monday – Friday, 8:00 AM – 5:00 PM CST).
Skills
- Decision Making
- Scheduling Appointments
- Microsoft Office
Qualifications
- Years of experience: 2 years
- Experience level: Experienced
Randstad is a world leader in matching great people with great companies. Our experienced agents will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temporary-to-permanent or permanent opportunities, no one works harder for you than Randstad.
Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.
At Randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact HRsupport@randstadusa.com.
Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including: medical, prescription, dental, vision, AD&D, and life insurance offerings, short-term disability, and a 401K plan (all benefits are based on eligibility).
This posting is open for thirty (30) days.
It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.
Job Tags
Hourly pay, Permanent employment, Temporary work, Work experience placement, Work at office, Remote work, Monday to Friday, Shift work, Day shift